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Meaningful Use Quality Measures May Be Meaningless

Cheryl Clark, for HealthLeaders Media, May 10, 2012

We should have sympathy for embattled healthcare providers who must meet certain quality measures to comply with Meaningful Use and other incentive payment rules. They, and the entities that were supposed to vet the rules on quality measures to reflect accurate, useable electronic health records, have encountered some head-spinning problems.

It's got to be a tough job, like herding cats, to get consensus in a time of rapid, massive health system change.

But there have been delays and errors, "rampant inconsistencies" in results, large development cost overruns, and a highly critical 76-page Government Accountability Office report. Now, many frustrated providers are asking whether the measures, and all the work they have to do to collect them, will really improve quality.

The problem, in a nutshell, is that many of these measures, such as those evaluating stroke care or prevention of thromboembolism, were endorsed in settings that used hand-written notes in medical records. Now those notes must be adapted for use by EHR systems. The process is complicated and technical. And in understatement, the transition has been bumpy.

Think of it as trying to print a photo of a friend you took with a first-generation low-res digital camera. Your friend is barely recognizable, awash in large boxy pixels. According to many providers' remarks in recent weeks, the true clinical picture —for example, did or didn't the patient get a particular drug, and at what dose?— is lost in translation.

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